The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Banking and Insurance
BILL: SB 312
INTRODUCER: Senator Diaz
SUBJECT: Telehealth
DATE: November 30, 2021
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Smith Brown HP Favorable
2. Johnson Knudson BI Favorable
3. RC
I. Summary:
SB 312 removes a provision in the definition of “telehealth” that excludes audio-only telephone
calls. The bill also amends a provision that, in practice, will allow a telehealth provider to issue a
renewal prescription for a controlled substance listed in Schedule III, IV, or V of s. 893.03, F.S.,
through telehealth, within the scope of his or her practice, and in accordance with other state and
federal laws. Currently, telehealth providers are prohibited from prescribing controlled
substances through telehealth unless the prescription is for the treatment of a psychiatric
disorder, inpatient treatment at a hospital, the treatment of a patient receiving hospice services, or
the treatment of a resident in a nursing home facility.
1
The bill narrows this prohibition to the
prescribing of only Schedule II controlled substances through telehealth, except under those
specific circumstances.
The bill provides an effective date of July 1, 2022.
II. Present Situation:
Telehealth
Relevant Terminology
Section 456.47, F.S., defines the term “telehealth” as the use of synchronous or asynchronous
telecommunications technology by a telehealth provider to provide health care services,
including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a
patient; transfer of medical data; patient and professional health-related education; public health
services; and health administration. Section 456.47(1)(a), F.S., provides that the term does not
include audio-only telephone calls, e-mail messages, or facsimile transmissions.
1
Section 456.47(2)(c), F.S.
REVISED: BILL: SB 312 Page 2
“Synchronous” telehealth refers to the live, real-time, or interactive transmission of information
between a patient and a health care provider during the same time period. The use of live video
to evaluate and diagnosis a patient would be considered synchronous telehealth.
“Asynchronous” telehealth refers to the transfer of data between a patient and a health care
provider over a period of time and typically in separate time frames. This is commonly referred
to as “store-and-forward.”
Florida Telehealth Providers
In 2019, the Legislature authorized Florida-licensed health care providers
2
to use telehealth to
deliver health care services within their respective scopes of practice. The bill became effective
on July 1, 2019.
3
The bill also authorized out-of-state health care providers to use telehealth to deliver health care
services to Florida patients if they register with the Department of Health (DOH) or the
applicable board
4
and meet certain eligibility requirements.
5
A registered out-of-state telehealth
provider may use telehealth, within the relevant scope of practice established by Florida law and
rule, to provide health care services to Florida patients but is prohibited from opening an office
in Florida and from providing in-person health care services to patients located in Florida.
Telehealth providers who treat patients located in Florida must be one of the licensed health care
practitioners listed below
6
and be either Florida-licensed, licensed under a multi-state health care
licensure compact of which Florida is a member state, or registered as an out-of-state telehealth
provider:
Behavioral Analyst
Acupuncturist
Allopathic physician
Osteopathic physician
Chiropractor
Podiatrist
Optometrist
Nurse
Pharmacist
Dentist
Dental Hygienist
Midwife
Speech Therapist
2
Section 456.47(1)(b), F.S.
3
Chapter 2019-137, s. 6, Laws of Fla.
4
Under s. 456.001(1), F.S., the term “board” is defined as any board, commission, or other statutorily created entity, to the
extent such entity is authorized to exercise regulatory or rulemaking functions within DOH or, in some cases, within DOH’s
Division of Medical Quality Assurance.
5
Section 456.47(4), F.S.
6
Section 456.47(1)(b), F.S. These are professionals licensed under s. 393.17; part III, ch. 401; ch. 457; ch. 458; ch. 459; ch.
460; ch. 461; ch. 463; ch. 464; ch. 465; ch. 466; ch. 467; part I, part III, part IV, part V, part X, part XIII, and part XIV, ch.
468; ch. 478; ch. 480; part II and part III, ch. 483; ch. 484; ch. 486; ch. 490; or ch. 491. BILL: SB 312 Page 3
Occupational Therapist
Radiology Technician
Electrologist
Orthotist
Pedorthist
Prosthetist
Medical Physicist
Emergency Medical Technician
Paramedic
Massage Therapist
Optician
Hearing Aid Specialist
Clinical Laboratory Personnel
Respiratory Therapist
Psychologist
Psychotherapist
Dietician/Nutritionist
Athletic Trainer
Clinical Social Worker
Marriage and Family Therapist
Mental Health Counselor
The Legislature also passed HB 7067 in 2019 that would have required an out-of-state telehealth
provider to pay an initial registration fee of $150 and a biennial registration renewal fee of $150.
Subsequently, the bill was vetoed by the Governor and did not become law.
7
On March 16, 2020, Florida Surgeon General Scott Rivkees executed DOH Emergency Order
20-002 authorizing certain out-of-state physicians, osteopathic physicians, physician assistants,
and advanced practice registered nurses to provide telehealth in Florida without the need to
register as a telehealth provider under s. 456.47(4), F.S.
8
Five days later, the Surgeon General
executed DOH Emergency Order 20-003
9
to also authorize certain out-of-state clinical social
workers, marriage and family therapists, mental health counselors, and psychologists to provide
telehealth in Florida without the need to register as a telehealth provider under s. 456.47(4), F.S.
These state emergency orders were extended and expired on June 26, 2021.
10
Out-of-state health
7
Transmittal Letter from Governor Ron DeSantis to Secretary of State Laurel Lee (June 27, 2019) available at
https://www.flgov.com/wp-content/uploads/2019/06/06.27.2019-Transmittal-Letter-3.pdf (last visited Nov. 23, 2021).
8
Department of Health, State of Florida, Emergency Order DOH No. 20-002 (Mar. 16, 2020) available at
http://floridahealthcovid19.gov/wp-content/uploads/2020/03/filed-eo-doh-no.-20-002-medical-professionals-03.16.2020.pdf
(last visited Nov. 23, 2021).
9
Department of Health, State of Florida, Emergency Order DOH No. 20-003 (Mar. 21, 2020) available at
https://s33330.pcdn.co/wp-content/uploads/2020/03/DOH-EO-20-003-3.21.2020.pdf (last visited Nov. 23, 2021).
10
Florida Board of Medicine, Important Updates for Health Care Providers Regarding Expiration of Emergency Orders
(July 1, 2021) available at https://r.bulkmail.flhealthsource.gov/mk/mr/JV-U0AMitwBXlP7zcFx3Djqu1KfE1B57JaGN-
nnNySmOjEY5xGSsIyII28XjOGeZ4yKv9rWQUryqAibmdrixNZdgE9Q61dmUoHRF1Rnyijg -ewyAl_rZBT8c (last visited
Nov. 23, 2021). BILL: SB 312 Page 4
care practitioners are no longer authorized to perform telehealth services for patients in Florida
unless they become licensed or registered in Florida.
Florida Medicaid Program
The Medicaid program is a joint federal-state program that finances health coverage for
individuals, including eligible low-income adults, children, pregnant women, elderly adults and
persons with disabilities.
11
The Centers for Medicare & Medicaid Services (CMS) within the
U.S. Department of Health and Human Services (HHS) is responsible for administering the
federal Medicaid program. Florida Medicaid is the health care safety net for low-income
Floridians. The Agency for Health Care Administration (AHCA) administers Florida’s program
and state and federal funds finance the program.
12
Medicaid enrollees generally receive benefits through one of two service-delivery systems: fee-
for-service (FFS) or managed care. Under FFS, health care providers are paid by the state
Medicaid program for each service provided to a Medicaid enrollee. Under managed care,
AHCA contracts with private managed care plans for the coordination and payment of services
for Medicaid enrollees. The state pays the managed care plans a capitation payment, or fixed
monthly payment, per recipient enrolled in the managed care plan. In Florida, the majority of
Medicaid recipients receive their services through a managed care plan contracted with AHCA
under the Statewide Medicaid Managed Care (SMMC) program.
13
Telemedicine Coverage under the Florida Medicaid Program
Florida Medicaid covers telemedicine in both the managed care and fee-for-service delivery
systems. Medicaid health plans have broad flexibility in covering telemedicine services.
14
On
January 30, 2020, the U.S. Secretary of the Department of Health and Human Services issued the
first declaration of a national public health emergency due to COVID-19; and the declaration
remains in effect today.
15
Effective April 3, 2020, and throughout the COVID-19 public health
emergency, AHCA will provide for the reimbursement of audio-only telehealth services
16
in the
managed care and fee-for-service delivery systems when rendered by licensed physicians
11
Medicaid.gov, Medicaid, available at https://www.medicaid.gov/medicaid/index.html (last visited Nov. 23, 2021).
12
Section 20.42, F.S.
13
Id.
14
Agency for Health Care Administration, Florida Medicaid Health Care Alert, Medicaid Telemedicine Guidance for
Medical and Behavioral Health Providers (Mar. 18, 2020) available at
https://ahca.myflorida.com/Medicaid/pdffiles/provider_alerts/2020_03/Medicaid_Telemedicine_Guidance_20200318.pdf
(last visited Nov. 23, 2021).
15
U.S. Department of Health and Human Services, Public Health Emergency Declarations (Oct. 15, 2021) available at
https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx (last visited Nov. 23, 2021). The declaration lasts
for the duration of the emergency or 90 days; however the Secretary may extend it.
16
Agency for Health Care Administration, COVID-19 Medicaid Information, available at COVID-19 Alerts Medicaid
Information (myflorida.com) (last viewed Nov. 23, 2021). BILL: SB 312 Page 5
(including psychiatrists), advanced practice registered nurses, and physician assistants.
17,18
During the public health emergency, Medicaid health plans are required to cover telemedicine
services in “parity” with face-to-face services, meaning the health plan must cover services via
telemedicine in a manner no more restrictive than the health plan would cover the service face-
to-face.
19
Under the fee-for service delivery system and in times of non-emergency, Florida Medicaid
generally reimburses only for synchronous telemedicine services provided using audio-visual
equipment.
20
Effective April 16, 2020, and throughout the public health emergency, AHCA will
provide for the reimbursement of audio-only behavioral health services for Medicaid
reimbursement under the fee-for service and managed care delivery systems when video
capability was not available.
21
As a condition for reimbursement, a behavioral health provider
must have documented that the enrollee did not have access to audio and video technology
necessary for the service to be fully provided via telemedicine.
22
The Federal Health Insurance Portability and Accountability Act (HIPAA)
23
HIPAA Privacy Rule
24
The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects
personal health information. The HIPAA Privacy Rule sets national standards for when protected
health information (PHI) may be used and disclosed. Only certain entities and their business
associates are subject to HIPAA’s provisions. These “covered entities” include health plans,
health care providers; and health care clearinghouses.
The Privacy Rule gives individuals privacy and confidentiality rights with respect to their
protected PHI, including rights to examine and obtain a copy of their health records in the form
and manner they request, and to ask for corrections to their information. In addition, the Privacy
Rule permits the use and disclosure of health information needed for patient care and other
important purposes.
17
Agency for Health Care Administration, Statewide Medicaid Managed Care (SMMC) Policy Transmittal: 2020-20 (Apr. 3,
2020) available at
https://ahca.myflorida.com/Medicaid/statewide_mc/pdf/2018-23_plan_comm/PT_2020-20_COVID-19_State-of-
Emergency_Telemedicine_Services.pdf (last visited Nov. 23, 2021).
18
2021 Senate Bill 700 also amended the definition of telehealth in s. 456.47, F.S., to include audio-only telephone calls.
Agency for Health Care Administration, Senate Bill 700 Analysis (Feb. 15, 2021) (on file with the Senate Committee on
Health Policy).
19
Id.
20
Agency for Health Care Administration, Senate Bill 852 Analysis (Feb. 1, 2021) (on file with the Senate Committee on
Health Policy).
21
Agency for Health Care Administration, Florida Medicaid Health Care Alert, Medicaid Telemedicine Flexibilities for
Behavioral Health Providers During the COVID-19 State of Emergency (Apr. 16, 2020) available at
https://ahca.myflorida.com/Medicaid/pdffiles/provider_alerts/2020_03/Medicaid_Telemedicine_Guidance_20200318.pdf
(last visited Nov. 23, 2021).
22
Id.
23
Centers for Medicare & Medicaid Services, Medicare Learning Network Booklet, HIPAA Basics for Providers: Privacy,
Security, and Breach Notification Rules (May. 2021) available at https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf (last visited Nov. 23, 2021).
24
45 C.F.R. Part 160 and Subparts A and E of Part 164. BILL: SB 312 Page 6
The Privacy Rule protects PHI held or transmitted by a covered entity or its business associate,
in any form, whether electronic, paper, or verbal. PHI includes information that relates to any of
the following:
The individual’s past, present, or future physical or mental health or condition;
The provision of health care to the individual; or
The past, present, or future payment for the provision of health care to the individual.
HIPAA Security Rule
25
The HIPAA Security Rule specifies safeguards that covered entities and their business associates
must implement to protect electronic PHI (ePHI) confidentiality, integrity, and availability.
Covered entities and business associates must develop and implement reasonable and appropriate
security measures through policies and procedures to protect the security of ePHI they create,
receive, maintain, or transmit. Each entity must analyze the risks to ePHI in its environment and
create solutions appropriate for its own situation. What is reasonable and appropriate depends on
the nature of the entity’s business as well as its size, complexity, and resources.
Under the Security Rule, covered entities must:
Ensure the confidentiality, integrity, and availability of all ePHI they create, receive,
maintain, or transmit;
Identify and protect against reasonably anticipated threats to the security or integrity of the
ePHI;
Protect against reasonably anticipated, impermissible uses or disclosures; and
Ensure compliance by their workforce.
When developing and implementing Security Rule compliant safeguards, covered entities and
their business associates may consider all of the following:
Size, complexity, and capabilities;
Technical, hardware, and software infrastructure;
The costs of security measures; and
The likelihood and possible impact of risks to ePHI.
Covered entities must review and modify security measures to continue protecting ePHI in a
changing environment.
HIPAA Breach Notification Rule
26
The HIPAA Breach Notification Rule requires covered entities to notify affected individuals; the
federal HHS; and, in some cases, the media of a breach of unsecured PHI. Generally, a breach is
an impermissible use or disclosure under the Privacy Rule that compromises the security or
privacy of PHI.
The impermissible use or disclosure of PHI is presumed to be a breach unless the covered entity
demonstrates a low probability that the PHI has been compromised based on a risk assessment
of, at a minimum, the following factors:
25
45 C.F.R. Part 160 and Subparts A and C of Part 164.
26
45 C.F.R. Subpart D. BILL: SB 312 Page 7
The nature and extent of the PHI involved, including the types of identifiers and the
likelihood of re-identification;
The unauthorized person who used the PHI or to whom the disclosure was made;
Whether the PHI was actually acquired or viewed; and
The extent to which the risk to the PHI has been mitigated.
Most notifications must be provided without unreasonable delay and no later than 60 days
following the breach discovery. Notifications of smaller breaches affecting fewer than 500
individuals may be submitted to HHS annually. The Breach Notification Rule also requires
business associates of covered entities to notify the covered entity of breaches at or by the
business associate.
Notification of Enforcement Discretion during Public Health Emergency
Covered health care providers acting in good faith will not be subject to penalties for violations
of the HIPAA Privacy Rule, the HIPAA Security Rule, or the HIPAA Breach Notification Rule
that occur in the good faith provision of telehealth during the public health emergency.
27
On
March 17, 2020, the federal Department of Health & Human Services (HHS) Office for Civil
Rights (OCR) issued a Notification of Enforcement of Discretion, meaning that the OCR may
exercise its enforcement discretion and not pursue penalties for HIPPA violations against health
care providers that serve patients through everyday communication technologies during the
public health emergency.
28
If a provider follows the terms of the Notification and any applicable
OCR guidance, it will not face HIPAA penalties if it experiences a hack that exposes protected
health information from a telehealth session.
29
Jurisdiction and Venue for Telehealth-related Actions
30
For purposes of s. 456.47, F.S., any act that constitutes the delivery of health care services is
deemed to occur at the place where the patient is located at the time the act is performed or in the
patient’s county of residence. Venue for a civil or administrative action initiated by the DOH, the
appropriate board, or a patient who receives telehealth services from an out-of-state telehealth
provider, may be located in the patient’s county of residence or in Leon County.
Controlled Substance Prescribing through Telehealth
Controlled Substances Generally
Chapter 893, F.S., sets forth the Florida Comprehensive Drug Abuse Prevention and Control Act.
This chapter classifies controlled substances into five schedules in order to regulate the
manufacture, distribution, preparation, and dispensing of the substances. The scheduling of
27
U.S. Department for Health and Human Services Office for Civil Rights, FAQs on Telehealth and HIPAA during the
COVID-10 nationwide public health emergency (Mar. 2020) available at https://www.hhs.gov/sites/default/files/telehealth-
faqs-508.pdf (last visited Nov. 23, 2021).
28
Press Release, U.S. Department of Health and Human Services, OCR Announces Notification of Enforcement Discretion
for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency (Mar. 17, 2021)
available at https://www.hhs.gov/about/news/2020/03/17/ocr-announces-notification-of-enforcement-discretion-for-
telehealth-remote-communications-during-the-covid-19.html (last visited Nov. 23, 2021).
29
Supra note 25.
30
Section 456.47(5), F.S. BILL: SB 312 Page 8
substances in Florida law is generally consistent with the federal scheduling of substances under
21 U.S.C. s. 812:
A Schedule I substance has a high potential for abuse and no currently accepted medical use
in treatment in the United States and its use under medical supervision does not meet
accepted safety standards. Examples include heroin and lysergic acid diethylamide (LSD).
A Schedule II substance has a high potential for abuse, a currently accepted but severely
restricted medical use in treatment in the United States, and abuse may lead to severe
psychological or physical dependence. Examples include cocaine and morphine.
A Schedule III substance has a potential for abuse less than the substances contained in
Schedules I and II, a currently accepted medical use in treatment in the United States, and
abuse may lead to moderate or low physical dependence or high psychological dependence
or, in the case of anabolic steroids, may lead to physical damage. Examples include lysergic
acid; ketamine; and some anabolic steroids.
A Schedule IV substance has a low potential for abuse relative to the substances in Schedule
III, a currently accepted medical use in treatment in the United States, and abuse may lead to
limited physical or psychological dependence relative to the substances in Schedule III.
Examples include alprazolam, diazepam, and phenobarbital.
A Schedule V substance has a low potential for abuse relative to the substances in Schedule
IV, a currently accepted medical use in treatment in the United States, and abuse may lead to
limited physical or psychological dependence relative to the substances in Schedule IV.
Examples include low dosage levels of codeine, certain stimulants, and certain narcotic
compounds.
Federal Law
31
The Ryan Haight Online Pharmacy Consumer Protection Act of 2008
32
amended the federal
Controlled Substances Act, to prohibit a practitioner from issuing a “valid prescription” for a
controlled substance through the Internet without having first conducted at least one in-person
medical evaluation, except in certain circumstances. Thereafter, the prescriber may prescribe
controlled substances to that patient via Internet or a phone call. The Act offers seven exceptions
to the in-person exam. One such exception occurs when the Secretary of the federal Department
of Health and Human Services (HHS) has declared a public health emergency.
Federal Guidance during the COVID-19 Public Health Emergency
On January 31, 2020, the Secretary of HHS issued a public health emergency.
33
On March 16,
2020, the federal Drug Enforcement Agency (DEA) published a COVID-19 Information page on
the Diversion Control Division website, authorizing DEA-registered practitioners, authorized
designated DEA-registered practitioners to issue prescriptions for all Schedule II-V controlled
substances to patients without first conducting an in-person medical evaluation during the public
health emergency, provided all of the following conditions are met:
31
21 U.S.C. s. 829.
32
Pub. L. No. 110-425 (2008).
33
Determination that a Public Health Emergency Exists, Alex M. Azar II, Secretary of U.S. Department of Health and
Human Services (January 31, 2020) available at https://www.phe.gov/emergency/news/healthactions/phe/Pages/2019-
nCoV.aspx (last visited Nov. 23, 2021). BILL: SB 312 Page 9
The prescription is issued for a legitimate medical purpose by a practitioner acting in the
usual course of his/her professional practice.
The evaluation is conducted using an audio-visual, real-time, two-way interactive
communication system.
The practitioner is acting in accordance with applicable federal and state law.
34
Florida Law
Under Florida law, controlled substance providers are required to conduct an in-person physical
examination prior to issuing a prescription for a controlled substance.
35
During the 2018
legislative session, s. 456.44, F.S., was amended
36
to authorize prescribers to prescribe a three-
day supply of a Schedule II opioid
37
or up to a seven-day supply if medically necessary. The
prescribing limits on Schedule II opioids do not apply to prescriptions for acute pains related to
cancer, a terminal condition, pain treated with palliative care, or a traumatic injury with an Injury
Severity Score of 9 or higher.
38
That section also requires a prescriber and dispenser to report to and review the Prescription
Drug Monitoring Program database known as E-FORCSE (Electronic-Florida Online Reporting
Controlled Substance Evaluation) to review a patient’s controlled substance dispensing history
prior to prescribing or dispensing a Schedule II-IV controlled substance for patients 16 years
older.
39
These limitations and requirements apply to practitioners providing services in-person
and through telehealth.
Section 456.47(2)(c), F.S.,
40
prohibits telehealth providers from prescribing any controlled
substance unless the controlled substance is prescribed for:
The treatment of a psychiatric disorder;
Inpatient treatment at a licensed hospital;
The treatment of a patient receiving hospice services; or
The treatment of a resident of a nursing home facility.
34
Diversion Control Division, U.S. Department of Justice Drug Enforcement Administration, COVID-19 Information Page,
available at https://www.deadiversion.usdoj.gov/coronavirus.html (last visited Nov. 23, 2021). Letter from Thomas
Prevoznik, Deputy Assistant Administrator, Diversion Control Division, U.S. Department of Justice Drug Enforcement
Administration, to DEA Qualifying Practitioners and Other Practitioners, (Mar. 31, 2020) available at
https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-
022)(DEA068)%20DEA%20SAMHSA%20buprenorphine%20telemedicine%20%20(Final)%20+Esign.pdf last visited Nov.
23, 2021).
35
Section 456.44, F.S.
36
Ch. 2018-13, Laws of Fla.
37
All opioids are controlled substances. Opioids range in classification between Schedule I and Schedule V.
38
Section 456.44(1)(a), F.S.
39
Section 893.055, F.S.
40
Ch. 2019-137, Laws of Fla. BILL: SB 312 Page 10
Florida DOH Emergency Order No. 20-002
The same day that the HHS Secretary authorized qualified prescribers to prescribe Schedule II-V
controlled substances, Surgeon General Rivkees issued DOH Emergency Order No. 20-002,
41
which suspended s. 456.47(2)(c), F.S., and authorized specified Florida-licensed prescribers
42
to
issue a renewal prescription for a Schedule II-IV controlled substance only for an existing patient
for the purpose of treating chronic nonmalignant pain without conducting another physical
examination of the patient. This emergency order was extended
43
and expired on June 26,
2021.
44
III. Effect of Proposed Changes:
Section 1 of the bill amends s. 456.47(1)(a), F.S., to remove a provision in the definition of
“telehealth” that excludes audio-only telephone calls. This change does not impose a direct
impact on Florida Medicaid but would allow Medicaid to elect to reimburse for audio-only
telephone calls.
Section 1 of the bill also amends s. 456.47(2)(c), F.S. Currently, telehealth providers are
prohibited from prescribing controlled substances through telehealth unless the prescription is
for: the treatment of a psychiatric disorder, inpatient treatment at a hospital, the treatment of a
patient receiving hospice services, or the treatment of a resident in a nursing home facility. The
bill narrows this prohibition to the prescribing of only Schedule II controlled substances through
telehealth except under those specific circumstances. In practice, this change will authorize a
telehealth provider to issue a renewal prescription for a controlled substance listed in Schedule
III, IV, or V of s. 893.03, F.S., through telehealth, within the scope of his or her practice, and in
accordance with other state and federal laws.
Under current law, no provider may prescribe a Schedule I drug under any circumstances.
Florida law requires a prescriber to perform an in-person physical examination prior to
prescribing a controlled substance for the treatment of chronic nonmalignant pain. All
prescribers and dispensers of controlled substances must comply with ch. 893, F.S., by
consulting and reporting to the Prescription Drug Monitoring Program database.
The applicable board, or DOH if there is no board, may adopt rules to administer this section of
statute.
45
41
Department of Health, State of Florida, Emergency Order DOH No. 20-002 (Mar. 16, 2020) available at
http://floridahealthcovid19.gov/wp-content/uploads/2020/03/filed-eo-doh-no.-20-002-medical-professionals-03.16.2020.pdf
(last visited Nov. 23, 2021).
42
Physicians, osteopathic physicians, physician assistants, or advanced practice registered nurses that have designated
themselves as a controlled substance prescribing practitioner on their practitioner profiles pursuant to s. 456.44, F.S.
43
Department of Health, State of Florida, Emergency Order DOH No. 20-011 (June 30, 2020) available at
https://floridahealthcovid19.gov/wp-content/uploads/2020/06/DOH-Emergency-Order-DOH-No.-20-011.pdf (last visited
Nov. 23, 2021).
44
Florida Board of Medicine, Important Updates for Health Care Providers Regarding Expiration of Emergency Orders
(July 1, 2021) available at https://r.bulkmail.flhealthsource.gov/mk/mr/JV-U0AMitwBXlP7zcFx3Djqu1KfE1B57JaGN-
nnNySmOjEY5xGSsIyII28XjOGeZ4yKv9rWQUryqAibmdrixNZdgE9Q61dmUoHRF1Rnyijg -ewyAl_rZBT8c (last visited
Nov. 23, 2021).
45
Section 456.47(7), F.S. BILL: SB 312 Page 11
Section 2 of the bill provides an effective date of July 1, 2022.
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None.
C. Trust Funds Restrictions:
None.
D. State Tax or Fee Increases:
None.
E. Other Constitutional Issues:
None.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
None.
C. Government Sector Impact:
According to AHCA, the bill will have an operational impact on the agency that can be
absorbed using current resources. Since the bill allows, but does not require, AHCA to
reimburse for audio-only telephone calls, there is no fiscal impact to the Florida Medicaid
program.
46
VI. Technical Deficiencies:
None.
46
Agency for Health Care Administration, Senate Bill 312 Bill Analysis, (Oct. 15, 2021) (on file with the Senate Committee
on Banking and Insurance). BILL: SB 312 Page 12
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill substantially amends section 456.47 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
None.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.